A case report: Neuroimaging in an atypical presentation of Parkinson’s disease

Abstract

Introduction: Parkinson’s disease (PD) is the second leading neurodegenerative disorder in the world. The diagnosis of idiopathic Parkinson’s disease (IPD) is mainly through clinical presentation of motor and non-motor symptoms. Motor symptoms include tremor, bradykinesia and rigidity. Atypical parkinsonism may pose a challenge in diagnosing IPD. Functional neuroimaging can assist in diagnosing IPD and in differentiating it from atypical parkinsonism due to other neurodegenerative aetiologies.
Patient presentation: We present a case report of a patient with atypical parkinsonism and mild neurocognitive disorder.
Management and outcome: Neuroimaging revealed IPD, distinguishing it from other causes of neurocognitive disorders. The patient received multidisciplinary team (MDT) input and appropriate medication, including a fixed combination of carbidopa and levodopa, rivastigmine, venlafaxine and quetiapine with improvement of his symptomatology.
Conclusion: Neuroimaging assisted in establishing the diagnosis and guiding treatment.
Contribution: Although evidence and studies are needed for definitive use in clinical practice, there is supportive evidence to suggest the diagnostic utility of these modalities in parkinsonian syndromes.